Short-term assessment of left ventricular function after coronary artery bypass grafting

Ahmed L. Dukhan; Abd El Megeed M. Ramadan; Basem A. Hafez; Peter A. Rashed

doi:10.35810/ects.v2i2.118

Ahmed L. Dukhan Cardiothoracic Surgery Department, Faculty of Medicine, Menofia University, Menofia, Egypt
Abd El Megeed M. Ramadan Cardiothoracic Surgery Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
Basem A. Hafez Cardiothoracic Surgery, Faculty of Medicine, Menofia University, Menofia, Egypt
Peter A. Rashed Cardiothoracic surgery department, Shark El Madina Hospital, Alexandria, Egypt

DOI: https://doi.org/10.35810/ects.v2i2.118

Keywords: coronary artery bypass grafting, Left ventricular function, Surgical revascularization

Abstract

Background: The effect of coronary artery bypass grafting on postoperative left ventricular function is still the subject of ongoing studies. The degree of recovery and its duration have not been precisely determined, and the published data are discordant. The objective of this study was to assess the effect of surgical revascularization on left ventricular systolic function.

Methods: We prospectively studied 50 consecutive patients who underwent elective isolated coronary artery bypass grafting in the period from January 2017 to November 2017. All patients had echocardiography preoperatively, pre-discharge, and at 3 and 6 months postoperatively. Left ventricular end-systolic volume, left ventricular end-diastolic volume, stroke volume, and ejection fraction were measured in all patients.

Results: The mean age was 57.22±7.04 years. The mean number of grafts was 2.60±1.02. Improvement in Canadian Cardiovascular Society (CCS) score from (2.72 ± 1.03) preoperatively to [(0.12 ± 0.39), p<0.001] after six months was achieved. Additionally, improvement in the patient New York Heart Association (NYHA) score occurred from (1.70 ± 0.97) preoperatively to [(0.12 ± 0.33), p<0.001] after six months. A significant improvement in left ventricular function occurred as demonstrated by improvement in mean left ventricular ejection fraction from (54.14±9.80) % to [(62.40 ± 4.18) %, p<0.001] at six months. The mean total hospital stay was 5.62±1.51 days. The mean total intensive care unit length of stay was 47.16±25.73 hours. Two patients (4%) had re-exploration for bleeding, and postoperative myocardial infarction occurred in three patients (6%). One patient (2%) had postoperative neurocognitive dysfunction, and 3 patients (6%) had postoperative atrial fibrillation. Two patients (4%) suffered from superficial wound infection. There was no hospital mortality.

Conclusion: Patients undergoing CABG experienced an improvement in left ventricular contractile function at six months postoperatively. Further studies are required to evaluate the changes after 6 months.